Visconti, Matthew L

Visconti, Matthew L is an individual health care provider with primary practice located at 1114 Charlevoix Ave , Petoskey MI 49770-9701. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Visconti, Matthew L can be contacted via phone (231) 439-9700.

Contact Information

Primary practice address
1114 Charlevoix Ave Petoskey MI 49770-9701
Phone: (231) 439-9700
Fax: (231) 439-9709
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 4301407390 Michigan

Profile Details

NPI number 1306883202
LBN Legal business name Visconti, Matthew L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2006
Last updated Feb 12th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306883202 NPPES
Michigan MEDICAID 4926793
Michigan MEDICAID 4777030
Michigan MEDICAID 4732181
Michigan MEDICAID 4356252

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